Individual
BRYAN KEITH MELANCON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
NP
Contact information
Practice address
8585 PICARDY AVE, BATON ROUGE, LA 70809
(225) 763-4764
(225) 763-4549
Mailing address
8585 PICARDY AVE, BATON ROUGE, LA 70809-3748
(225) 763-4764
(225) 763-4549
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
87222-4549
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1470872
—
LA
Enumeration date
07/01/2005
Last updated
06/19/2018
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